| NPI | 1801835723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN L COOK Program Director 704-471-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC MHL023-002) |
| Additional Taxonomies | 251B00000X Case Management (Licence: NC mhl023002) |
| 251C00000X Day Training, Developmentally Disabled Services (Licence: NC MHL023002) | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 251V00000X Voluntary or Charitable (Licence: NC MHL023002) | |
| 261Q00000X Clinic/Center (Licence: NC MHL023-002) | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-09-18 |